TY - JOUR
AU - Bitler, Marianne
AU - Carpenter, Christopher
TI - Effects of Direct Care Provision to the Uninsured: Evidence from Federal Breast and Cervical Cancer Programs
JF - National Bureau of Economic Research Working Paper Series
VL - No. 26140
PY - 2019
Y2 - August 2019
DO - 10.3386/w26140
UR - http://www.nber.org/papers/w26140
L1 - http://www.nber.org/papers/w26140.pdf
N1 - Author contact info:
Marianne Bitler
Department of Economics
University of California, Davis
One Shields Avenue
Davis, CA 95616
E-Mail: bitler@ucdavis.edu
Christopher Carpenter
Department of Economics
Vanderbilt University
VU Station B, Box #351819
2301 Vanderbilt Place
Nashville, TN 37235
E-Mail: christopher.s.carpenter@vanderbilt.edu
M3 - presented at "Health Economics Program Meeting", April 29, 2016
AB - Much research has studied the health effects of expanding insurance coverage to low-income people, but there is less work on the direct provision of care to the uninsured. We study the two largest federal programs aimed at reducing breast and cervical cancer among uninsured women in the US: one that paid for cancer screenings with federal funds and one that paid for cancer treatments under state Medicaid programs. Using variation in rollout of each program across states from 1991-2005, we find that funding for cancer treatment did not significantly increase most types of cancer screenings for uninsured women. In contrast, funding for cancer detection significantly increased breast and cervical cancer screenings among 40-64 year old uninsured women, with much smaller effects for insured women (who were not directly eligible). Moreover, we find that these program-induced screenings significantly increased detection of early stage pre-cancers and cancers of the breast but had no significant effect on early stage or other cancers of the cervix. Our results suggest that direct provision can significantly increase healthcare utilization among vulnerable populations.
ER -